RAGBRAI XXXIX Vendor Application

RAGBRAI XXXIX Vendor Application

**MUST BE RECEIVED BY JUNE 17, 2011**

Business/Organization Information

Name of Contact:
Email: / Phone: / ()
Organization Name:
Address:
Street Address / Apartment/Unit #
City / State / ZIP Code
SALES TAX PERMIT # OR FED ID # OR SOCIAL SECURITY #

Will you need Electricity? Yes____ No_____ (Check one)

If yes, how many watts*? ______(It is highly encouragedto be self contained with a quiet generator.)

*All items are limited to 110-volt regular current. Understand that we need to place a restriction on how much power is available upon receiving the total loads. Thank you for your cooperation!

Items being used: Lighting Refrigeration Coffee Maker Roaster Crock pot Frying Pan Other______

Please list all hazardous materials that will be at your site: (gasoline, propane, etc.)______

What size booth space is needed: Front/Width____ft.Depth_____ft.

Will you be on your property?_____

What are your items and prices you will be selling? Please list (include on separate sheets if necessary):

1st Item______Price $ ______2nd Item ______Price $ ______3rd Item______Price $______

4th Item______Price $ ______5th Item ______Price $ ______6th Item______Price $______

How many people do you plan to serve? ______

What hours are you planning to be open during this time frame? ______a.m. to _____ p.m.*

*All RAGBRAI Vendors must close operations from approximately 5:30 p.m. until 6:30 p.m. Please refer to the Vendor Guidelines for more information.

Electrical Fee: $50.00 (If electrical connection is requested.)

Vendor Fee (for approved applicants)

Non Profit Local* $100.00

For Profit Local* $200.00

Out of town – non-food $250.00

Out of town – food $300.00

*If you are within the Bondurant-Farrar School District you will be considered “local”

Total Fees and Information Enclosed with This Application:

Proof of Liability Insurance (enclosed)

Vendor Fee:$______

Electrical Fee: $______

Total Enclosed:$______(Make checks payable to City of Bondurant)

APPLICATIONS AND ALL FEES ARE DUE BY: June 17, 2011
FINAL NOTIFICATIONS TO VENDORS WILL BE PROVIDED BY: June 24, 2011

In order to be considered as a vendor for Bondurant RAGBRAI XXXIX, all applications must be received by June 17, 2011. Applications will be reviewed as they are received by the City and approved by the RAGBRAI Committee. Proof of $1,000,000 General Liability Insurance is required (with RAGBRAI Bondurant listed as additional insured or additional interest). Evidence of liability insurance and all payments MUST accompany this application form. No exceptions will be made regarding the liability insurance requirement or the June 17, 2011, deadline.

Waiver (Signature is required)

I/we understand the risks involved and, in consideration for the opportunity to participate in Bondurant RAGBRAI, do hereby release any and all rights and claims for damages I/we may have now or hereafter against the Bondurant RAGBRAI Committee, the City of Bondurant, Polk County, or their respective agents, employees, representatives, successors or assigns, for loss, damage, injury or liability of any nature which may be sustained in connection with my/our participation in Bondurant RAGBRAI. I/we also agree to assume responsibility for any property which I/we damage and will provide my/our own insurance for our booth.

By signing this form I am also acknowledging that I have read the Vendor Guidelines for RAGBRAI XXXIX in Bondurant, and will comply with all vendor guidelines therein.

Signature of Applicant:

Print ApplicantName:

Organization Name:

Please complete both pages of this form and mail/return with all of the requirements satisfied. Make sure to include liability insurance copy and checks payable to:

City of Bondurant

200 2nd Street NE, PO Box 37

Bondurant, IA 50035.

Note:All applications are pending approval of the Vendor Committee assigned by the RAGBRAI Steering Committee of Bondurant.
You will be notified once application has been approved or denied.

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